oa Indo-Pacific Journal of Phenomenology - Getting under the skin : the inscription of dermatological disease on the self-concept



Psychological factors have long been associated with the onset, maintenance and exacerbation of many cutaneous disorders (Newell, 2000, p. 8; Papadopoulos, Bor & Legg, 1999, p. 107). Chronic cutaneous disease is often visible to others so that social factors in coping and adjustment are thus highly relevant (Papadopoulos, et al., 1999, p. 107). Psychological factors tend, however, to be overlooked in the dermatological treatment domain when the skin problem is not regarded as life threatening (MacGregor, 1990 as cited in Papadopoulos, et al., 1999, p. 113). In 2004, at a meeting of the Editorial Board of <u>Dermatology Nursing, </u> the need for studies presenting the patient's perspective on living with a skin disease was discussed. It was thought that qualitative exploration of the patient's experience of cutaneous disease would provide medical and mental health care professionals with valuable insights and important information to help improve dermatology patient care (Hill, 2004, p. 399). More specifically, Papadopoulos et al. (1999, p. 122) posit that qualitative exploration of dermatological patients' lived experience might help provide insight into the efficacy of coping strategies, the need for psychological counsel, and also the need for a more holistic understanding of this patient population rather than maintaining a dichotomous focus on either the mind or the body. <br>Research in the field is currently characterised by (a) a predominance of quantitative studies, the design of which results in inevitable loss of in-depth information regarding the experiential world of sufferers of cutaneous disease (Hill, 2004, p. 399; Papadopoulos, et al., 1999, p. 122), and (b) a dearth of studies investigating the impact of disfiguring skin conditions on the self-concept. In order to address this lack, and simultaneously to contribute towards mapping the psycho-dermatological terrain in need of qualitative exploration, this paper attempts to integrate the findings of relevant studies in the fields of both dermatology and psychology, with specific focus on women suffering from psoriasis, a common chronic disorder of the skin, and the impact of this on the various dimensions of self. The primary aim of this paper is, however, to prompt qualitative - and, in particular, phenomenological - research in the area of body disfigurement and self-concept in order to elucidate the lived experiences of people afflicted with disfiguring dermatological conditions, and as such to promote necessary change in the therapeutic domain.


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